title: Secular trends in hospital emergency department visits for dental care in Kansas City, Missouri, 2001-2006.
abstract: OBJECTIVE
  We determined the trends, risk factors, and costs of emergency department (ED) visits for dental complaints during a six-year period in Kansas City, Missouri (KCMO).
  
  
  METHODS
  We used de-identified hospital discharge data from all facilities serving KCMO during 2001-2006. Using the International Classification of Diseases, Ninth Revision codes, we determined both counts and rates of ED visits related to toothache or tooth injury and analyzed the discharge diagnosis and costs of these visits. We used multivariable regression analysis to assess risk factors for the ED visits for dental complaints.
  
  
  RESULTS
  We found a significant increasing trend in dental complaint visits during the six-year period (from 13.1% to 19.0%, p < 0.01). Dental caries accounted for 20.4%, pulpitis or periapical abscess accounted for 14.8%, dental injury accounted for 8.7%, temporomandibular joint (TMJ) disorders accounted for 1.5%, and all other unspecified dental diseases accounted for 54.6% of the ED visits for dental complaints. The mean charge was approximately $360 per visit and was highest for TMJ disorders ($747) and lowest for unspecified other dental diseases ($277). Self-pay (38.3%) and Medicaid (32.3%) constituted the majority of the payment sources. Multivariable regression analysis indicated that self-payers, nonwhite people, adults, people with lower family income, and weekends were associated with increased use of ED visits for dental complaints.
  
  
  CONCLUSIONS
  There was a significant increasing trend in dental complaint-related ED visits. EDs have become an important site for people with dental problems to seek urgent care, particularly for individuals who self-pay or are on Medicaid.
authors.affiliation: Division of Community Dentistry, Department of Pediatric Dentistry and Community Dentistry, University of Tennessee Health Science Center College of Dentistry, Memphis, TN 38136, USA. lhong2@uthsc.edu
authors.forename: Liang
authors.initials: L
authors.lastname: Hong
authors.forename: Arif
authors.initials: A
authors.lastname: Ahmed
authors.forename: Michael
authors.initials: M
authors.lastname: McCunniff
authors.forename: Yifei
authors.initials: Y
authors.lastname: Liu
authors.forename: Jinwen
authors.initials: J
authors.lastname: Cai
authors.forename: Gerald
authors.initials: G
authors.lastname: Hoff
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D019538:Health Care Surveys; D017722:Hospital Charges / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D019458:Insurance Coverage / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D008923:Missouri / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D017062:Small-Area Analysis; D012959:Socioeconomic Factors; D009057:Stomatognathic Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D014076:Tooth Diseases / Q000175:diagnosis / Q000453:epidemiology; D055815:Young Adult